How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $20.42 | Professional | None | $14.45 | $20.42 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | None | $29.51 | $29.51 | $34.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Facility | None | $37.15 | $37.15 | $44.67 |
BCBS North Carolina Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $19.05 | Professional | None | $15.14 | $17.78 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $20.42 Median $28.18 Typical High $102.33 | Facility | None | $20.42 | $28.18 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $11.75 Median $26.92 Typical High $38.90 | Professional | None | $11.75 | $26.92 | $38.90 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.22 Typical High $12.88 | Professional | None | $8.32 | $11.22 | $12.88 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $8.13 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $3.24 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 54 · Surgery only | $12.30 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.45 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.62 | $2.04 | $2.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.89 Median $13.80 Typical High $27.54 | Professional | 51 · Multiple procedures | $5.89 | $13.80 | $27.54 |
Where North Carolina sits
The same service costs 2.9 times more in Rhode Island than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 20th of 51
$17.78
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.